The Safety of the Laryngeal Mask Airway in Adenotonsillectomy: A Systematic Review and Meta-Analysis
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View abstract on PubMed
Summary
This summary is machine-generated.Laryngeal mask airway (LMA) is a safe alternative to endotracheal tube (ETT) intubation for adenotonsillectomy, reducing operative time. Careful patient selection is crucial due to an approximate 8% conversion rate to ETT.
Area Of Science
- Anesthesiology
- Otolaryngology
- Surgical Safety
Background
- Adenotonsillectomy is a common surgical procedure globally.
- Endotracheal tube (ETT) intubation is the standard for airway management.
- Laryngeal mask airway (LMA) use in adenotonsillectomy has been investigated.
Purpose Of The Study
- To systematically review and meta-analyze the safety and efficacy of LMA versus ETT in adenotonsillectomy.
- To compare perioperative respiratory adverse events (PRAEs) between LMA and ETT.
- To evaluate secondary outcomes including conversion rates, desaturations, and surgical time.
Main Methods
- Systematic review and meta-analysis of randomized controlled trials and comparative studies up to 2022.
- Followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Assessed primary outcome of PRAEs and secondary outcomes like conversion rate, desaturations, nausea/vomiting, and surgical time.
Main Results
- Twelve studies (4176 patients) were analyzed.
- No significant difference in PRAEs (OR 1.16), desaturations (OR 0.79), or minor complications (OR 0.89).
- LMA use resulted in significantly shorter operative time (mean difference -4.38 min) and emergence time (mean difference -4.15 min).
Conclusions
- LMA is a safe alternative to ETT for adenotonsillectomy.
- LMA requires less operative time compared to ETT.
- Careful patient selection and clinical judgment are essential, considering the ~8% conversion rate to ETT.
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